Phonoechocardiographic identification of chordal snap in hypertrophic cardiomyopathy.

In three patients with hypertrophic cardiomyopathy, a late systolic click following mid systolic murmur was recognized. M-mode and two-dimensional echocardiography showed the presence of systolic anterior motion of the chordae tendineae in all cases. Phonoechocardiographic studies showed that the time of the click always coincided with the endpoint of mild anterior motion of the chordae tendineae. The click was considered to be a chordal snap.